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How To Stop Dry Mouth: What You Should Know

Saliva, which contains essential protein molecules, electrolytes, and minerals, is critical to good oral dentistry health. Saliva lubricates and cleanses the mouth, preserves and bathes tooth structure, neutralizes acids that cause cavities, limits growth of bacteria, viruses, and fungi, dissolves and breaks down food, assists with taste, keeps the mouth moist (no dry mouth which helps with speaking and eating), and facilitates the retention of dentures.

Research has shown that healthy, unmedicated older adults do not have any significant decrease in saliva flow. Loss of saliva and dry mouth are not the result of normal aging, but are instead associated with illness, disease, medication treatments, and medication.

Reduced saliva flow increases the harmful effects of the organisms of the mouth, causing dental cavities, bleeding gums, plaque, burning mouth, pain, soft tissue infections, and cracks. In addition, an individual may have difficulty speaking, tasting, and swallowing food. Dentures do not fit well or feel comfortable when saliva is reduced.

Older adults take many over-the-counter and prescription medications for chronic medical conditions and disorders. For many of these medications, decrease in saliva flow is a common side effect. In fact, over 500 prescriptions and over-the-counter medications cause dry mouth (xerostomia). The medications most often associated with dry mouth are:

• tricyclic antidepressants
• antipsychotics
• antianxiety
• antihistamines
• decongestants
• antihypertensives
• diuretics
• antiparkinsonism
• anticholinergics

Although medication use is frequently associated with dry mouth, certain medical diseases, conditions, or treatments reduce saliva flow. Examples are

• head and neck radiation treatment for cancer
• Sjögren's syndrome
• poorly controlled diabetes
• bone marrow transplantation
• HIV
• cystic fibrosis
• scleroderma
• amyloidosis
• sarcoidosis
• vitamin deficiency
• thyroid disorders
• mental stress and depression

By Denise J. Fedele, DMD, MS

How To Know If You Have A TMJ Problem With Your Bite

Problems with the way your teeth fit together occur in many different ways. Some bite problems cause discomfort or even pain, and that pain can masquerade as problems that you would not readily associate with your teeth. Some bite problems can cause major damage to your teeth without producing any obvious discomfort.

There are some pretty simple ways that anyone can detect TMJ when a problem with the bite is causing or at least contributing to pain or discomfort.

The clench test: With your mouth empty so there is nothing between your teeth to bite on, close your teeth together and squeeze hard. If clenching your teeth together causes any sign of discomfort in any tooth, you have a disharmony in your bite.

Teeth that are sensitive to cold often get that way from the extra pounding they take if any part of that tooth strikes before the rest of the teeth contact during closure. Use the clench test to see if the extra sensitivity is related to an uneven bite. Squeeze hard. If you can make any tooth hurt by empty mouth clenching, the bite is probably the main reason for the sensitivity. This is a good way to find out if a new filling or crown is "high." If it hurts when you clench, it is probably not in perfect harmony with a correct bite. You should be able to bite hard and grind your teeth together in all directions without feeling discomfort in any tooth if your bite is perfect. The exception to this is if you have advanced periodontal disease, you may have several teeth that can't accept firm biting, but even then, you should not normally feel pain in a single tooth when biting.

If biting hard causes pain or discomfort in the jaw joint, (you may feel it just in front of your ear), you can suspect a possible relationship between your bite and a temporomandibular joint (TMJ) problem. It may be associated with a structural disorder in your TMJ, but more often the pain is coming from certain muscles that move your jaw joints to accommodate a bite that is not in harmony with your TMJs. Your dentist should be able to diagnose the exact source of the pain.

Look for severe wear on your teeth, as this is another sign that your bite is not in harmony. If you have worn all the enamel off the biting edges of your teeth, you will see a darker colored surface. This is dentin and it will wear down seven times faster than the much harder enamel that you've already worn through. So ask your dentist to evaluate what is causing so much wear. This wear can be especially damaging when it is on your front teeth, so if you notice your lower front teeth have worn down to dentin, have your bite checked. Better yet, don't wait till all the enamel is gone. Schedule a visit to your dentist office. Correcting your bite may stop or at least slow down the wear process.

By Peter E. Dawson, DDS